Abstract
We report the case of a 51-year-old woman who had suffered from right knee pain and stiffness for 40 years. Her symptoms had gradually worsened over the past 5 years. One year previously, when she first visited our clinic, plain radiographs and CT scan images had revealed synovial chondromatosis over the right knee. At the current admission, follow-up MRI showed synovial masses around the knee and worsening of endosteal cortical scalloping in the patella, femoral condyle, and tibial plateau. After diagnosis on the basis of frozen sections, the patient had total excision of the lesions and total knee athroplasty. Histological examination revealed synovial chondromatosis in the joint cavity and grade 1 chondrosarcoma invasion into the adjacent bone. In long-standing synovial chondromatosis, presentation with aggravated symptoms and deterioration on imaging findings should alert clinicians to the potential for malignant change.
Highlights
We report the case of a 51-year-old woman who had suffered from right knee pain and stiffness for 40 years
Synovial chondromatosis is very difficult to distinguish from secondary synovial chondrosarcoma solely on clinical, radiological or histological criteria
The histological diagnosis was grade 1 chondrosarcoma arising from synovial chondromatosis (Fig. 4).There were multinodular cartilaginous islands and loose bodies in the joint cavity
Summary
We report the case of a 51-year-old woman who had suffered from right knee pain and stiffness for 40 years. Her symptoms had gradually worsened over the past 5 years. One year previously, when she first visited our clinic, plain radiographs and CT scan images had revealed synovial chondromatosis over the right knee. The clinical features alone are not helpful for distinguishing them, and no definite imaging criteria can differentiate synovial chondromatosis from low-grade synovial chondrosarcoma (2-5). Synovial chondromatosis is very difficult to distinguish from secondary synovial chondrosarcoma solely on clinical, radiological or histological criteria. The diagnosis is usually made on the basis of a combination of clinical, imaging and histological criteria, as we did in our present case
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